Rhinosinusitis medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]

Overview

Medical Therapy

Supportive Therapy

Supportive therapy for symptomatic relief is the mainstay of treatment in both cases of acute and chronic rhinosinusitis. These include:[1][2]

  • Analgesics and antipyretics, to manage the fever and facial pain associated with rhinosinusitis.
  • Saline irrigation, which helps relieve nasal obstruction.
  • Intranasal corticosteroids, which proved to be beneficial in both acute and chronic rhinosinusitis.
  • Oral glucocorticoids can be given for a short period in the case of chronic rhinosinusitis.[3]

Antibiotics

In addition to symptomatic relief, antibiotics can be added in the case of acute bacterial rhinosinusitis if there is no improvement within 10 days of supportive treatment, worsening symptoms after initial improvement or severe symptoms at initial presentation.[1][2]. In chronic rhinosinusitis, brad-spectrum antibiotics can be combined with oral glucocorticoids for a brief period of 4-6 weeks.[3]

References

  1. 1.0 1.1 Rosenfeld RM, Piccirillo JF, Chandrasekhar SS, Brook I, Ashok Kumar K, Kramper M, Orlandi RR, Palmer JN, Patel ZM, Peters A, Walsh SA, Corrigan MD (2015). "Clinical practice guideline (update): adult sinusitis". Otolaryngol Head Neck Surg. 152 (2 Suppl): S1–S39. doi:10.1177/0194599815572097. PMID 25832968.
  2. 2.0 2.1 Chow AW, Benninger MS, Brook I, Brozek JL, Goldstein EJ, Hicks LA, Pankey GA, Seleznick M, Volturo G, Wald ER, File TM (2012). "IDSA clinical practice guideline for acute bacterial rhinosinusitis in children and adults". Clin. Infect. Dis. 54 (8): e72–e112. doi:10.1093/cid/cir1043. PMID 22438350.
  3. 3.0 3.1 Ozturk F, Bakirtas A, Ileri F, Turktas I (2011). "Efficacy and tolerability of systemic methylprednisolone in children and adolescents with chronic rhinosinusitis: a double-blind, placebo-controlled randomized trial". J. Allergy Clin. Immunol. 128 (2): 348–52. doi:10.1016/j.jaci.2011.04.045. PMID 21624649.

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